NPIMap

Organization Active NPI

Premise Health of Minnesota Medical PC

Doing business as AGCO Family Wellness Center

  • Multi-Specialty Clinic/Center
  • Jackson, MN
National Provider Identifier
1174431233
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF MINNESOTA MEDICAL PC
Doing business as
AGCO Family Wellness Center
Practice address
203 Industrial Park
Jackson, MN 56143-9447
Phone
(517) 847-5199
Fax
(507) 540-1135
NPI assigned
Aug 31, 2026
Last updated
Aug 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edward William Schwartz
Title
President
Phone
(602) 739-4561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

203 Industrial Park
Jackson, MN 56143-9447

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Other names 1

  • AGCO Family Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Be Well Health Center-St Cloud6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

203 Industrial Park
Jackson, MN 56143

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1174431233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 INDUSTRIAL PARK",
            "city": "JACKSON",
            "state": "MN",
            "postal_code": "561439447",
            "telephone_number": "517-847-5199",
            "fax_number": "507-540-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF MINNESOTA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-739-4561"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AGCO Family Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.